As the patient says a long "ee-ee ee" sound, the examiner hears a long "aaaaaa" sound.

When the patient speaks in a normal voice, the examiner can hear a sound but cannot exactly distinguish what is being said

As the patient says a long "ee-ee-ee sound, the examiner also hears a long "ee-ee-ee" sound.

As the patient repeatedly says "ninety-nine," the examiner clearly hears the words "ninetynine."

Voice sounds are faint, muffled, and almost inaudible when the patient whispers "one, two, three" in a very soft voice